Race/Ethnicity and health – Some concluding remarks

1. Race/Ethnicity and health – Some concluding remarks Finn Diderichsen University of Copenhagen

2. The routine use in epidemiology: • Together with social position often used as rather crude confounders, implying a lot of residual confounding and biased results on riskfactors effect. • A major source of ecological bias in area based studies – unhealthy Norwegians in Oslo may live in immigrant dense areas and generate high mortality rates • The very heterogenous patterns of health related selection into migration

3. Scientific relevance of the concept • Does the etiological role of the concept actually dissolve into Nazroo’s 6 mediating factors: SES, culture, migration, genes, access to service and discrimination ? • Or are the health effects of the 6 factors actually aggrevated/mediated through the existence and use of the concept ? • The concept ”lives its own life” and reproduces the inequities through the belief of a common anciestry and fate

4. A parallel: Social position • We find the concept useful even when we know that the health effect is mediated by several welldefined pathways and causes • Because it reflects upstream mechanisms distributing power and wealth in society • And because health differencies across social position reflects inequities • But the concept of social positon may not ”live its own life”

5. Policy relevance of the race/ethnicity concept • It represent an important category of inequity • But is it a relevant category for collective action for health equity – similary to what unions have been historically ?

6. Policy relevance of the concept • Welfare states are important contributing, but not sufficent determinant of population health • Welfare states demand a shared sense of collective values and fate – is categorizations then more part of the problem or part of the solution? • Welfare states demand that everybody are treated equally and with respect – we still have far to go !